Provider Demographics
NPI:1750717922
Name:MOVEIT PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:MOVEIT PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-388-0692
Mailing Address - Street 1:315 BARNETTE ST
Mailing Address - Street 2:#74638
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-4638
Mailing Address - Country:US
Mailing Address - Phone:907-388-0692
Mailing Address - Fax:
Practice Address - Street 1:665 ASPEN HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99712-1111
Practice Address - Country:US
Practice Address - Phone:907-388-0692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK170261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy